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Treatment of large avulsion injury in perianal, sacral, and perineal regions by island flaps or skin graft combined with vacuum assisted closure

BACKGROUND: Traumatic avulsion injuries to the anus, although uncommon, can result in serious complications and even death. Management of anal avulsion injuries remains controversial and challenging. This study aimed to investigate the clinical effects of treating large skin and subcutaneous tissue...

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Autores principales: Hu, Fu Xing, Hu, Xiao Xuan, Yang, Xue Lin, Han, Xing Hai, Xu, Yong Bo, Li, Kun, Yan, Li, Chu, Hai Bo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6582469/
https://www.ncbi.nlm.nih.gov/pubmed/31215452
http://dx.doi.org/10.1186/s12893-019-0529-1
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author Hu, Fu Xing
Hu, Xiao Xuan
Yang, Xue Lin
Han, Xing Hai
Xu, Yong Bo
Li, Kun
Yan, Li
Chu, Hai Bo
author_facet Hu, Fu Xing
Hu, Xiao Xuan
Yang, Xue Lin
Han, Xing Hai
Xu, Yong Bo
Li, Kun
Yan, Li
Chu, Hai Bo
author_sort Hu, Fu Xing
collection PubMed
description BACKGROUND: Traumatic avulsion injuries to the anus, although uncommon, can result in serious complications and even death. Management of anal avulsion injuries remains controversial and challenging. This study aimed to investigate the clinical effects of treating large skin and subcutaneous tissue avulsion injuries in the perianal, sacral, and perineal regions with island flaps or skin graft combined with vacuum assisted closure. METHODS: Island flaps or skin graft combined with vacuum assisted closure, diverting ileostomy, the rectum packed with double-lumen tubes around Vaseline gauze, negative pressure drainage with continuous distal washing, wounds with skin grafting as well as specialized treatment were performed. RESULTS: The injuries healed in all patients. Six cases had incomplete perianal avulsion without wound infection. Wound infection was seen in four cases with annular perianal avulsion and was controlled, and the separated prowl lacuna was closed. The survival rate in 10 patients who underwent skin grafting was higher than 90%. No anal stenosis was observed after surgery, and ileostomy closure was performed at 3 months (six cases) and 6 months (four cases) after surgery, respectively. CONCLUSIONS: Covering a wound with an island flap or skin graft combined with vacuum assisted closure is successful in solving technical problems, protects the function of the anus and rapidly seals the wound at the same time.
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spelling pubmed-65824692019-06-26 Treatment of large avulsion injury in perianal, sacral, and perineal regions by island flaps or skin graft combined with vacuum assisted closure Hu, Fu Xing Hu, Xiao Xuan Yang, Xue Lin Han, Xing Hai Xu, Yong Bo Li, Kun Yan, Li Chu, Hai Bo BMC Surg Research Article BACKGROUND: Traumatic avulsion injuries to the anus, although uncommon, can result in serious complications and even death. Management of anal avulsion injuries remains controversial and challenging. This study aimed to investigate the clinical effects of treating large skin and subcutaneous tissue avulsion injuries in the perianal, sacral, and perineal regions with island flaps or skin graft combined with vacuum assisted closure. METHODS: Island flaps or skin graft combined with vacuum assisted closure, diverting ileostomy, the rectum packed with double-lumen tubes around Vaseline gauze, negative pressure drainage with continuous distal washing, wounds with skin grafting as well as specialized treatment were performed. RESULTS: The injuries healed in all patients. Six cases had incomplete perianal avulsion without wound infection. Wound infection was seen in four cases with annular perianal avulsion and was controlled, and the separated prowl lacuna was closed. The survival rate in 10 patients who underwent skin grafting was higher than 90%. No anal stenosis was observed after surgery, and ileostomy closure was performed at 3 months (six cases) and 6 months (four cases) after surgery, respectively. CONCLUSIONS: Covering a wound with an island flap or skin graft combined with vacuum assisted closure is successful in solving technical problems, protects the function of the anus and rapidly seals the wound at the same time. BioMed Central 2019-06-18 /pmc/articles/PMC6582469/ /pubmed/31215452 http://dx.doi.org/10.1186/s12893-019-0529-1 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Hu, Fu Xing
Hu, Xiao Xuan
Yang, Xue Lin
Han, Xing Hai
Xu, Yong Bo
Li, Kun
Yan, Li
Chu, Hai Bo
Treatment of large avulsion injury in perianal, sacral, and perineal regions by island flaps or skin graft combined with vacuum assisted closure
title Treatment of large avulsion injury in perianal, sacral, and perineal regions by island flaps or skin graft combined with vacuum assisted closure
title_full Treatment of large avulsion injury in perianal, sacral, and perineal regions by island flaps or skin graft combined with vacuum assisted closure
title_fullStr Treatment of large avulsion injury in perianal, sacral, and perineal regions by island flaps or skin graft combined with vacuum assisted closure
title_full_unstemmed Treatment of large avulsion injury in perianal, sacral, and perineal regions by island flaps or skin graft combined with vacuum assisted closure
title_short Treatment of large avulsion injury in perianal, sacral, and perineal regions by island flaps or skin graft combined with vacuum assisted closure
title_sort treatment of large avulsion injury in perianal, sacral, and perineal regions by island flaps or skin graft combined with vacuum assisted closure
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6582469/
https://www.ncbi.nlm.nih.gov/pubmed/31215452
http://dx.doi.org/10.1186/s12893-019-0529-1
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